SARETTA LANIECE GORDON-EDENBURGH
NPI 1619712825
Contractor in South Euclid, OH

Active since June 28, 2024
1405 VILLA DR, SOUTH EUCLID, OH 44121(216) 716-0242 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Saretta Laniece Gordon-edenburgh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SARETTA LANIECE GORDON-EDENBURGH (NPI 1619712825) is an individual contractor provider in South Euclid, Ohio, licensed in Ohio (SM696161) and active in the NPI registry since June 2024.

NPPES Registry Identity

NPI1619712825
Entity TypeIndividualFemale
Primary Taxonomy171W00000X
Provider Legal NameSARETTA LANIECE GORDON-EDENBURGH
Location Address1405 VILLA DRSouth Euclid, OH 44121-2903
Mailing Address1405 Villa DrSouth Euclid, OH 44121-2903 · (216) 716-0242
Sole ProprietorYes
Enumeration DateJune 28, 2024
NPPES CertifiedJune 28, 2024
NPI 1619712825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyContractorOther Service Providers
Taxonomy Code171W00000X
License Licensed in OH · SM696161
Definition
For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no relation to a provider's employment status.
1405 VILLA DR, South Euclid, OH 44121

Other Names 1

Other Name (5)Syreeta Laniece Gordon

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Saretta Gordon-edenburgh's NPI number?

The NPI number for Saretta Gordon-edenburgh is 1619712825. It was assigned to this individual provider in the NPPES registry on June 28, 2024. The provider is also known as Syreeta Laniece Gordon.

Where is Saretta Gordon-edenburgh located?

Saretta Gordon-edenburgh practices at 1405 Villa Dr, South Euclid, OH 44121. The listed phone number is (216) 716-0242.

What is Saretta Gordon-edenburgh's specialty?

The primary specialty registered for this NPI is Contractor with taxonomy code 171W00000X.

When was this NPI record last updated?

The NPPES record for Saretta Gordon-edenburgh was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.