| CASE NUMBER | I-200-24218-244731 |
| CASE STATUS | Certified |
| RECEIVED DATE | 8/5/2024 |
| DECISION DATE | 8/12/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | IT Manager |
| SOC CODE | 11-3021.00 |
| SOC TITLE | Computer and Information Systems Managers |
| FULL TIME POSITION | N |
| BEGIN DATE | 9/12/2024 |
| END DATE | 9/11/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | KA Dental Group WPB PA |
| TRADE NAME DBA | KA Dental |
| EMPLOYER ADDRESS1 | 1962 S. Military Trail |
| EMPLOYER ADDRESS2 | Suite A |
| EMPLOYER CITY | West Palm Beach |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33415 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +15618910775 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Patel |
| EMPLOYER POC FIRST NAME | Krupal |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Owner |
| EMPLOYER POC ADDRESS1 | 1962 S. Military Trail |
| EMPLOYER POC ADDRESS2 | Suite A |
| EMPLOYER POC CITY | West Palm Beach |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33415 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15618910775 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | contact@kadental.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Boyer |
| AGENT ATTORNEY FIRST NAME | Scott |
| AGENT ATTORNEY MIDDLE NAME | Jeffrey |
| AGENT ATTORNEY ADDRESS1 | 755 W. Big Beaver Road |
| AGENT ATTORNEY ADDRESS2 | Suite 1100 |
| AGENT ATTORNEY CITY | TROY |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 48084 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +12485199900 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | scott.boyer@ellisporter.com |
| LAWFIRM NAME BUSINESS NAME | Ellis Porter PLC |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | Michigan Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1962 S. Military Trail |
| WORKSITE ADDRESS2 | Suite A |
| WORKSITE CITY | West Palm Beach |
| WORKSITE COUNTY | PALM BEACH |
| WORKSITE STATE | FL |
| WORKSITE POSTAL CODE | 33415 |
| WAGE RATE OF PAY FROM | 55.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $51.43 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 4 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-12-09 |
