IndividualActive
Benjamin Kellum, DDS
NPI 1225481930 · Dentist · Pocatello, ID
Provider details
- NPI number
- 1225481930
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- D4772 (ID)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Idaho State University
Pocatello, ID 83209-0001
Phone: (208) 282-3289
Approximate (ZIP-level) locationGet directions
Mailing address
Idaho State University
Pocatello, ID 83209-0001
Registry dates
- Enumerated
- 2016-07-18
- Last updated
- 2016-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.