MEDICARE: CORDOVA FAMILY DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1376419754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORDOVA FAMILY DENTAL

Provider Business Mailing Address
First Line	:	1680 BONNIE LN
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-1529
Country	:	US
Telephone Number	:	901-667-6453
Fax Number	:	901-742-2693

Provider Business Practice Location Address
First Line	:	1680 BONNIE LN
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-1529
Country	:	US
Telephone Number	:	901-667-6453
Fax Number	:	901-742-2693

Authorized Official
Title or Position	:	DMD / OWNER
Name	:	AARON KNOP
Credential	:	DMD
Telephone Number	:	901-667-6453

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	02/10/2026

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Directions to “CORDOVA FAMILY DENTAL ” Practice Location

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