| CASE NUMBER | I-200-24213-235829 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/31/2024 |
| DECISION DATE | 8/7/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Staff Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/7/2024 |
| END DATE | 10/6/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Johnson Health Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 134 Elon Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Madison Heights |
| EMPLOYER STATE | VA |
| EMPLOYER POSTAL CODE | 24572 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +14344552480 |
| EMPLOYER PHONE EXT | 1109 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Saunders |
| EMPLOYER POC FIRST NAME | Sharon |
| EMPLOYER POC MIDDLE NAME | M. |
| EMPLOYER POC JOB TITLE | Chief Human Resources Officer |
| EMPLOYER POC ADDRESS1 | 134 Elon Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Madison Heights |
| EMPLOYER POC STATE | VA |
| EMPLOYER POC POSTAL CODE | 24572 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +14344552480 |
| EMPLOYER POC PHONE EXT | 1109 |
| EMPLOYER POC EMAIL | ssaunders@jhcvirginia.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Rhoads |
| AGENT ATTORNEY FIRST NAME | Mark |
| AGENT ATTORNEY MIDDLE NAME | B. |
| AGENT ATTORNEY ADDRESS1 | 1111 E. Main St. |
| AGENT ATTORNEY ADDRESS2 | Suite 2100 |
| AGENT ATTORNEY CITY | Richmond |
| AGENT ATTORNEY STATE | VA |
| AGENT ATTORNEY POSTAL CODE | 23219 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +18047753824 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | mrhoads@lawmh.com |
| LAWFIRM NAME BUSINESS NAME | McCandlish Holton, PC |
| STATE OF HIGHEST COURT | VA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 109 Clearview Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Madison Heights |
| WORKSITE COUNTY | AMHERST |
| WORKSITE STATE | VA |
| WORKSITE POSTAL CODE | 24572 |
| WAGE RATE OF PAY FROM | 187,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $153,858.00 |
| PW UNIT OF PAY | Year |
| 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 | 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 | Reitze |
| PREPARER FIRST NAME | Laura |
| PREPARER MIDDLE INITIAL | A. |
| PREPARER BUSINESS NAME | McCandlish Holton, PC |
| PREPARER EMAIL | lreitze@lawmh.com |
| BEGIN DATE CONVERTED | 2024-07-10 |
