Shane Russell William Pascoe, DMD

Dentist · Hurlburt Field, FL

Individual Active NPI

NPI number 1417453077

Practice location

113 Lielmanis Ave
Hurlburt Field, FL 32544-5613
Phone
(850) 881-1020

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NPI record

NPI
1417453077
Entity type
Individual (Type 1)
Enumeration date
April 3, 2018
Last updated
August 27, 2025
Certified
August 27, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DN23525 FL
Dentist 122300000X 23525 FL
Student in an Organized Health Care Education/Training Program 390200000X — —

About Dr. Pascoe

Shane Russell William Pascoe, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613. The NPI number 1417453077 was assigned on April 3, 2018 and the record was last updated on August 27, 2025.

Dr. Pascoe lists 2 licenses in the registry: #DN23525 (FL) for Dentist; #23525 (FL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shane Russell William Pascoe, DMD?

The NPI number is 1417453077.

What is the phone number of Dr. Pascoe?

The phone number listed for the practice location is (850) 881-1020.

Where is Dr. Pascoe located?

113 Lielmanis Ave, Hurlburt Field, FL 32544-5613.

What is the taxonomy code for Dr. Pascoe?

The primary taxonomy code is 122300000X – Dentist; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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