Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenneth Demetric Shumate, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417236613

Dr. Kenneth Demetric Shumate, DDS is a Student in an Organized Health Care Education/Training Program in Waldorf, Maryland. Practices as a sole proprietor. Licensed in Maryland and Virginia.

Licensed in
MD, VA
In the registry since
2011
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

3010 Crain Hwy Ste 202
Waldorf, MD 20601-2801
Phone: (240) 518-8928
Fax: (240) 518-8931
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 14944 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
General Practice Dentistry Taxonomy 1223G0001X · Licence 0401413457 (VA)

Record details

NPI number1417236613
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedAugust 5, 2011
Last updated in NPPESAugust 8, 2016

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