Individual provider Active NPI

Keoni Christian Lynam, DMD

  • Dentist
  • Fort Campbell, KY
National Provider Identifier
1992629554
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14282239-9926 Issued in UT
Practice address
5979 Desert Storm Ave
Fort Campbell, KY 42223-5514
Phone
(888) 217-4563
NPI assigned
Aug 6, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 14282239-9926 UT Primary

Addresses

Primary practice location

5979 Desert Storm Ave
Fort Campbell, KY 42223-5514

Mailing address

5979 Desert Storm Ave
Fort Campbell, KY 42223-5514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1992629554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5979 DESERT STORM AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 DESERT STORM AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235514",
            "telephone_number": "888-217-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNAM",
        "first_name": "KEONI",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-06",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "14282239-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.