MEDICARE: DR. CONNER ANDREW COURTNEY DDS

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	13218	TN

General Provider Information

NPI Number	:	1649106386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONNER ANDREW COURTNEY DDS

Provider Business Mailing Address
First Line	:	5000 CRUZE RD
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-4605
Country	:	US
Telephone Number	:	865-360-9803
Fax Number	:

Provider Business Practice Location Address
First Line	:	2719 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-4620
Country	:	US
Telephone Number	:	865-524-1265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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