OrganizationActive
Kellum Dental Clinic
NPI 1528280880 · Dental Clinic/Center · Tupelo, MS
Provider details
- NPI number
- 1528280880
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shaundi Little, Office Manager(662) 842-5080
- License
- 2554-90 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
505 Robins St
Tupelo, MS 38804-3715
Phone: (662) 842-5080
Fax: (662) 842-5896
Street-level locationGet directions
Mailing address
Po Box 1486
Tupelo, MS 38802-1486
Registry dates
- Enumerated
- 2007-05-03
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.