Paul R Maco, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021190 Issued in IL

Practice address

4590 Strom Thurmond Blvd
Columbia, SC 29207-5305

Phone

(803) 751-5178

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Moncrief Army Community Hospital

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Columbia, SC
  • NPI 1932304946
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1689679706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 CHAMPION HILL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292076022",
            "telephone_number": "803-751-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 STROM THURMOND BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075305",
            "telephone_number": "803-751-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACO",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Mackins-Hill, LPC
• Brandon Macknofsky
• Mary F. Maclachlan, PH.D.
• Ian Macleod
• Ryan Macnevin, M.D.
• Ashley Macon, LPC-I
• Jonathan T Macon, MD
• Brittlynn Rose Macpherson, FNP
• Macro-Health, Inc.
• Jourdan Macy, PHARM D.

• General Practice Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.