| CASE NUMBER | I-200-24260-339994 |
| CASE STATUS | Certified |
| RECEIVED DATE | 9/16/2024 |
| DECISION DATE | 9/23/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dental Services Coordinator |
| SOC CODE | 11-9111.00 |
| SOC TITLE | Medical and Health Services Managers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/23/2024 |
| END DATE | 9/22/2027 |
| 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 | Excel Dental Solutions Inc |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 5470 Lafayette Rd |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Indianapolis |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46254 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +13099660654 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Durshanapalli |
| EMPLOYER POC FIRST NAME | Srinivas |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 5470 Lafayette Rd |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Indianapolis |
| EMPLOYER POC STATE | IN |
| EMPLOYER POC POSTAL CODE | 46254 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +12032154687 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | drsrinu81@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Vemuru |
| AGENT ATTORNEY FIRST NAME | Suneil |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 1033 Sterling Road |
| AGENT ATTORNEY ADDRESS2 | Unit 104 |
| AGENT ATTORNEY CITY | Herndon |
| AGENT ATTORNEY STATE | VA |
| AGENT ATTORNEY POSTAL CODE | 20170 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +14109757575 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | support@immiservice.com |
| LAWFIRM NAME BUSINESS NAME | Vegesna and Vemuru Associates LLC |
| STATE OF HIGHEST COURT | MD |
| NAME OF HIGHEST STATE COURT | Maryland Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Affinity Family Dental |
| WORKSITE ADDRESS1 | 2158 Intelliplex Drive #114 |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Shelbyville |
| WORKSITE COUNTY | SHELBY |
| WORKSITE STATE | IN |
| WORKSITE POSTAL CODE | 46176 |
| WAGE RATE OF PAY FROM | 92,082.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $92,082.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 | 2025-11-09 |
