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Dr. Kenneth Demetric Shumate, DDS
General Practice Dentistry in Waldorf, Maryland
NPI 1417236613

Kenneth Demetric Shumate is a General Practice Dentistry based in Waldorf, MD and is specialized in General Practice. Kenneth Demetric Shumate practices in Waldorf, MD and has the professional credentials of DDS. The NPI Number for Kenneth Demetric Shumate is 1417236613 and holds a License No. (Maryland).

The current practice location address for Kenneth Demetric Shumate is 3010 Crain Hwy, Waldorf, MD and can be reached out via phone at 240-518-8928 and via fax at 240-518-8931.

Location: 3010 Crain Hwy, Waldorf, MD, 20601-2801
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417236613
Provider Name
Kenneth Demetric Shumate
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
3010 Crain Hwy, Waldorf, MD, 20601-2801
Phone Number
240-518-8928
Fax Number
240-518-8931
Provider Enumeration Date
08/05/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
067013800 05 MD
institution
Provider Business Practice Location Address Details
Address
3010 Crain Hwy
City
Waldorf
State
Maryland
Zip
20601-2801
Phone Number
240-518-8928
Fax Number
240-518-8931
person
Provider Business Mailing Address Details
Address
3010 Crain Hwy
City
Waldorf
State
Maryland
Zip
20601-2801
Phone Number
240-518-8928
Fax Number
240-518-8931
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
14944 (Maryland)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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