MEDICARE: 4D BABY STUDIO LLC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1245188390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	4D BABY STUDIO LLC

Provider Business Mailing Address
First Line	:	42101 N 41ST DR STE 15
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-3816
Country	:	US
Telephone Number	:	602-550-4778
Fax Number	:

Provider Business Practice Location Address
First Line	:	42101 N 41ST DR STE 15
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-3816
Country	:	US
Telephone Number	:	602-550-4778
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MS. DAWN MONCRIEF
Credential	:	ARDMS, RVS
Telephone Number	:	602-550-4778

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/18/2026

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