| CASE NUMBER | I-200-24191-182792 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/9/2024 |
| DECISION DATE | 7/16/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/1/2024 |
| END DATE | 9/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Dental Health Associates, P.A. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 10 Woodbridge Center Dr. |
| EMPLOYER ADDRESS2 | Suite 520 |
| EMPLOYER CITY | Woodbridge |
| EMPLOYER STATE | NJ |
| EMPLOYER POSTAL CODE | 07095 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +19089103129 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62121 |
| EMPLOYER POC LAST NAME | Armenta |
| EMPLOYER POC FIRST NAME | Kristin |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Director, Talent Acquisition |
| EMPLOYER POC ADDRESS1 | 10 Woodbridge Center Dr. |
| EMPLOYER POC ADDRESS2 | Suite 520 |
| EMPLOYER POC CITY | Woodbridge |
| EMPLOYER POC STATE | NJ |
| EMPLOYER POC POSTAL CODE | 07095 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +19089103129 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | karmenta@prosmile.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Wu |
| AGENT ATTORNEY FIRST NAME | Tiffany |
| AGENT ATTORNEY MIDDLE NAME | Chang |
| AGENT ATTORNEY ADDRESS1 | 18401 Von Karman Ave. |
| AGENT ATTORNEY ADDRESS2 | Suite 255 |
| AGENT ATTORNEY CITY | Irvine |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92612 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +19492610209 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | tchang@fragomen.com |
| LAWFIRM NAME BUSINESS NAME | Fragomen, Del Rey, Bernsen & Loewy, LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 200 W 2nd Street |
| WORKSITE ADDRESS2 | Suite 109 |
| WORKSITE CITY | Plainfield |
| WORKSITE COUNTY | UNION |
| WORKSITE STATE | NJ |
| WORKSITE POSTAL CODE | 07060 |
| WAGE RATE OF PAY FROM | 116,828.33 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $68,598.00 |
| PW UNIT OF PAY | Year |
| 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 | 1 |
| 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 | Herron |
| PREPARER FIRST NAME | Kaitlin |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Fragomen, Del Rey, Bernsen & Loewy, LLP |
| PREPARER EMAIL | kherron@fragomen.com |
| BEGIN DATE CONVERTED | 2024-01-10 |
