Provider Demographics
NPI:1881584852
Name:CARTER, JACOB LAWTON IV (DDS)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:LAWTON
Last Name:CARTER
Suffix:IV
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2484 SUNRISE RIDGE WAY APT 308
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-1276
Mailing Address - Country:US
Mailing Address - Phone:864-252-5621
Mailing Address - Fax:
Practice Address - Street 1:7315 CLINTON HWY STE A
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5225
Practice Address - Country:US
Practice Address - Phone:865-938-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN129141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice