| CASE NUMBER | I-200-24194-194402 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/12/2024 |
| DECISION DATE | 7/19/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Endodontist |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| FULL TIME POSITION | N |
| BEGIN DATE | 8/1/2024 |
| END DATE | 7/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Hudson Valley Dental Associates PLLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 474 Holiday Drive |
| EMPLOYER ADDRESS2 | Suite 1 |
| EMPLOYER CITY | Rutland |
| EMPLOYER STATE | VT |
| EMPLOYER POSTAL CODE | 05701 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +13154546000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Ximenes |
| EMPLOYER POC FIRST NAME | Juliana |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Global Immigration Manager |
| EMPLOYER POC ADDRESS1 | Team TAG Services, LLC |
| EMPLOYER POC ADDRESS2 | 800 W Fulton Market |
| EMPLOYER POC CITY | Chicago |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 60607 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +13154546000 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | juliana.ximenescoutinhodias@aspendental.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | O'Donoghue |
| AGENT ATTORNEY FIRST NAME | Robin |
| AGENT ATTORNEY MIDDLE NAME | Dana |
| AGENT ATTORNEY ADDRESS1 | O'Donoghue Law, LLC |
| AGENT ATTORNEY ADDRESS2 | 2067 Massachusetts Avenue, 5th Floor |
| AGENT ATTORNEY CITY | Cambridge |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 02140 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +16174929898 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | rdod@odonoghuelawllc.com |
| LAWFIRM NAME BUSINESS NAME | O'Donoghue Law, LLC |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 856 US Route 302 |
| WORKSITE ADDRESS2 | Unit A |
| WORKSITE CITY | Barre |
| WORKSITE COUNTY | BARRE CITY |
| WORKSITE STATE | VT |
| WORKSITE POSTAL CODE | 05641 |
| WAGE RATE OF PAY FROM | 125.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $117.28 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 3 |
| 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 | 2024-01-08 |
