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DR. BENJAMIN KELLUM DDS
NPI 1225481930
Dentist in Pocatello, ID

Active since July 18, 2016PECOS Enrolled
IDAHO STATE UNIVERSITY, POCATELLO, ID 83209(208) 282-3289 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Benjamin Kellum Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BENJAMIN KELLUM DDS (NPI 1225481930) is an individual dentist in Pocatello, Idaho, licensed in Idaho (D4772) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225481930
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. BENJAMIN KELLUMCredential: DDS
Location AddressIDAHO STATE UNIVERSITYPocatello, ID 83209-0001
Mailing AddressIdaho State UniversityPocatello, ID 83209-0001
Phone(208) 282-3289
Sole ProprietorYes
Enumeration DateJuly 18, 2016
✔ NPI 1225481930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in ID · D4772
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

IDAHO STATE UNIVERSITY, Pocatello, ID 83209
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Benjamin Kellum Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83209 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEVEN RANDALL LAWYER PHD
Psychologist (Cognitive & Behavioral)
IDAHO STATE UNIVERSITY, DEPARTMENT OF PSYCHOLOGY, STOP 8112
POCATELLO, ID 83209
Bannock County (208) 282-2142
DR. JENNIFER HOLST AU.D.
Audiologist
IDAHO STATE UNIVERSITY, 921 S. 8TH STOP 8116
POCATELLO, ID 83209
Bannock County (208) 282-3747
MR. THEODORE WILLIAM PETERSON O.T.R.
Occupational Therapist
IDAHO STATE UNIVERSITY, CAMPUS BOX 8045
POCATELLO, ID 83209
Bannock County (208) 282-4631
DR. ALEXANDER G URFER PT
Physical Therapist
IDAHO STATE UNIVERSITY, MAIL STOP 8045
POCATELLO, ID 83209
Bannock County (208) 282-4095
DR. JAMES E CREELMAN III DPT
Physical Therapist
IDAHO STATE UNIVERSITY, CAMPUS BOX 8045
POCATELLO, ID 83209
Bannock County (208) 282-4566
MRS. LORIANN HELGESON OTRL
Occupational Therapist
IDAHO STATE UNIVERSITY, CAMPUS STOP 8045
POCATELLO, ID 83209
Bannock County (208) 282-2590

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Kellum's NPI number?

The NPI number for Benjamin Kellum is 1225481930. It was assigned to this individual provider in the NPPES registry on July 18, 2016.

Where is Benjamin Kellum located?

Benjamin Kellum practices at Idaho State University, Pocatello, ID 83209. The listed phone number is (208) 282-3289.

What is Benjamin Kellum's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Benjamin Kellum enrolled in Medicare?

Yes. Benjamin Kellum is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Benjamin Kellum was last updated on July 18, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.