Doctor profile · Federal record
Dr. Kenneth Shumate, D.D.S
General Practice Dentistry · Student in an Organized Health Care Education/Training Program · General Practice Dentistry · Waldorf, MD
- NPI 1417236613
- 15 yrs on file
- Licensed in 2 states
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
3010 Crain Hwy, Suite 202
Waldorf, MD 206012801
(240) 518-8928
fax (240) 518-8931
Credentials & registration
- NPI registered
- August 2011 — 15 yrs on file
- Profile last updated
- August 8, 2016
- Specialty taxonomy
- 1223G0001X — NUCC code
- State licenses (2)
- Maryland #14944 · Virginia #0401413457
- Medicaid
- MD #067013800
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1417236613. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$94
Transactions
3
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Zimvie INC. | 3 | $93.68 |
By nature of payment
Frequently asked questions
What is Dr. Kenneth Shumate's medical specialty?
Dr. Kenneth Shumate practices General Practice Dentistry in Waldorf, MD.
Where does Dr. Kenneth Shumate practice?
Dr. Kenneth Shumate practices at 3010 Crain Hwy, Waldorf, MD 206012801. Office phone: 2405188928.
What is Dr. Kenneth Shumate's NPI?
Dr. Kenneth Shumate's National Provider Identifier (NPI) is 1417236613, issued by NPPES.