Individual provider Active NPI

Jonattan Eduardo Angulo-Ochoa, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Detroit, MI
National Provider Identifier
1861002719
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
2952000716 Issued in MI
Practice address
22201 Moross Rd Ste 155
Detroit, MI 48236-2152
Phone
(313) 499-4929
Fax
(313) 499-4953
NPI assigned
Aug 5, 2020
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 5315214666 MI
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 2952000716 MI Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 5315214665 MI

Addresses

Primary practice location

22201 Moross Rd Ste 155
Detroit, MI 48236-2152

Mailing address

22201 Moross Rd Ste 155
Detroit, MI 48236-2152
Phone (313) 499-4929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240707000015 MI Practitioner - DentistPractitioner - Maxillofacial Surgery 8527484690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Maxillofacial Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

27483 Dequindre Rd
Suite 204
Madison Heights, MI 48071-5711
Phone (248) 967-7326

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5315214665MIMDOral & Maxillofacial Surgery (D.M.D.)
5315214666MIMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jun 1, 2024 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jun 1, 2024 Accepting new patients

Locations

22201 Moross Rd
Ste 155
Detroit, MI 48236
Phone (313) 499-4775

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

11900 E 12 Mile Rd
Ste 210
Warren, MI 48093
Phone (586) 558-4700

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: jangulo1115213@direct.hfhs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1861002719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 155",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362152",
            "telephone_number": "313-499-4929",
            "fax_number": "313-499-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 155",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362152",
            "telephone_number": "313-499-4929",
            "fax_number": "313-499-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGULO-OCHOA",
        "first_name": "JONATTAN",
        "middle_name": "EDUARDO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-05",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "5315214666",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2952000716",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "5315214665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.