Kristen N Shumate, DDS

Individual provider Active NPI Public Health Dentistry · Mansfield, OH

NPI 1821229907 · NPPES record last updated Aug 9, 2010

Key facts

NPI
1821229907
Entity type
Individual (NPI type 1)
Primary specialty
Public Health Dentistry 1223D0001X
License
30-023066 (OH)
Practice address
600 W 3Rd St
Mansfield, OH 44906-2633
Phone
(419) 522-6191
Fax
(419) 526-4911
NPI assigned
Aug 6, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
30-023066OHMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shumate Dental LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 30-023066 OH Yes

Addresses

Primary practice location

600 W 3Rd St
Mansfield, OH 44906-2633

Mailing address

600 W 3Rd St
Mansfield, OH 44906-2633
Phone (419) 522-6191

Other providers in Mansfield, OH

All providers in Mansfield, OH · Public Health Dentistry in Ohio

Sources for this page

Verify at the official NPI Registry.