Healthcare Provider Details

I. General information

NPI: 1528176567
Provider Name (Legal Business Name): CYNTHIA LEE-HARDIN HIPP DDS, MSCR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 JOHN WESLEY GILBERT DRIVE
AUGUSTA GA
30912-0001
US

IV. Provider business mailing address

3867 INVERNESS WAY
AUGUSTA GA
30907-9030
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2716
  • Fax: 706-721-6778
Mailing address:
  • Phone: 843-830-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDNES000535
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number07317
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number3217
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN016010
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: