Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1417453077 Individual Practitioner Male Practitioner

Dr. Shane Russell William Pascoe , DMD

Dentist • Hurlburt Field, FL

Professional Overview & Biography Verified Profile Summary

Dr. Shane Pascoe, DMD is a registered healthcare professional specializing in Dentist in Hurlburt Field, FL. Practice services are available at 113 LIELMANIS AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

113 Lielmanis Ave

Hurlburt Field, FL 325445613

Telephone 8508811020
Associated Practice Facility / Clinic
🏢 1st Spcl Ops Medgrp-Hurlburt Facility NPI 1568442630

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Hurlburt Field, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.2 Yrs
Regional Practice Density
7 Specialists

Practicing in Hurlburt Field, FL (6414 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-08-27
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License FL DN23525

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License FL 23525

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Dr. Don Vongviphut , DO

General Practice

NPI 1003356684

Doctor of Osteopathic Medicine (D.O.)

Rebecca Dalton , LCSW

Social Worker - Clinical

NPI 1053665554

Licensed Clinical Social Worker

Sheri Roberts , PA

Physician Assistant

NPI 1073886909

Physician Assistant

Tyrus Colbert

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1093558397
Dr. Matthew Edgar , DO

Emergency Medicine

NPI 1104356880

Doctor of Osteopathic Medicine (D.O.)

Franklin Cordon

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1114736055

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location August 27, 2025

Registered at 113 LIELMANIS AVE, HURLBURT FIELD, FL 325445613 (Tel: 8508811020)

📍
Updated Business Mailing Address August 27, 2025

Registered at 113 LIELMANIS AVE, HURLBURT FIELD, FL 325445613

📍
Updated Practice Location June 20, 2018

Registered at 101 BODIN CIR, TRAVIS AFB, CA 94535 (Tel: 7074234300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2018

Dentist (License #23525 in FL)

NPI Profile Active April 03, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 03, 2018

Registered at 124 HIBISCUS AVE, GULF BREEZE, FL 325614322 (Tel: 8502324013)

📍
Updated Business Mailing Address April 03, 2018

Registered at 124 HIBISCUS AVE, GULF BREEZE, FL 325614322

👤
Provider Name / Credentials Updated April 03, 2018

Recorded as SHANE PASCOE, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 03, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417453077
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 03, 2018
Last Update: August 27, 2025
Sole Proprietor: No

Mailing Address

113 Lielmanis Ave

Hurlburt Field, FL 325445613

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.