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

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Waldorf, MD

No coordinates on file. Search this address in Google Maps

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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