Carly Anne Rachid

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN27902 Issued in FL

Practice address

2133 Pepperrell St BLDG 3352
Jbsa Lackland, TX 78236-5313

Phone

(321) 298-8995

NPI assigned

Mar 20, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Carly Anne Grimison Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417659145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 PEPPERRELL ST BLDG 3352",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 PEPPERRELL ST BLDG 3352",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365313",
            "telephone_number": "321-298-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHID",
        "first_name": "CARLY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN27902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "GRIMISON",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Gerard Prescott, CRNA
• Kathy Presper, FNP
• Sarah Renaghan Price
• Sharon Monica Quigley, NP
• Michael Joseph Rabener, DSC, EMPA-C
• Amanda Veling Radtke, MD
• Kevin Duane Rasmussen, DDS
• Kelly Anne Rayburn, PA-C
• Laura Elizabeth Reardon, PHD
• Kristina Reck, DMD

• General Practice Dentistry in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.