Periocare LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIOCARE LLC

Practice address

3070 N Highway 17 Ste 202
Mt Pleasant, SC 29466-9300

Phone

(843) 650-7171

NPI assigned

Jul 22, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Neda Azadivatan, DDS

Title

Owner/Dentist

Phone

(843) 650-7171

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neda Azadivatan-Le, D.D.S.

  • Periodontics
  • Surfside Beach, SC
  • NPI 1922121177
  NPD

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1043192057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N HIGHWAY 17 STE 202",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N HIGHWAY 17 STE 202",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669300",
            "telephone_number": "843-650-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIOCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "AZADIVATAN",
        "authorized_official_first_name": "NEDA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "843-650-7171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Federico Perez Quirante, MD
• Perfectly Fit Wellness, LLC
• Performance Insight, LLC
• Erica Periard, DC
• Felix Periard, DC
• Margaret Farrell Perkins, RN
• Gregory Ashley Perron, M.D.
• Shirlie B Perrone, PT
• Andrew Paul Perry, PH.D.
• Kathryn Blair Perry, MSR, OTR/L

• Periodontics in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.