| CASE NUMBER | I-200-24176-142117 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/24/2024 |
| DECISION DATE | 7/1/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dentist - General |
| 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 | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Sheikh & Shelat DDS Inc |
| TRADE NAME DBA | Modesto Kidz Dental |
| EMPLOYER ADDRESS1 | 2801 Coffee Road Blvd |
| EMPLOYER ADDRESS2 | Bldg B |
| EMPLOYER CITY | Modesto |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95355 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +12095783131 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Sojitra |
| EMPLOYER POC FIRST NAME | Prakash |
| EMPLOYER POC MIDDLE NAME | N/A |
| EMPLOYER POC JOB TITLE | Manager/DDS |
| EMPLOYER POC ADDRESS1 | 2801 Coffee Road |
| EMPLOYER POC ADDRESS2 | Bldg. B |
| EMPLOYER POC CITY | Modesto |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 95355 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15104566131 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | drpsojitra@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Baxley |
| AGENT ATTORNEY FIRST NAME | Shirley |
| AGENT ATTORNEY MIDDLE NAME | J |
| AGENT ATTORNEY ADDRESS1 | 130 Magnolia Point Drive |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Columbia |
| AGENT ATTORNEY STATE | SC |
| AGENT ATTORNEY POSTAL CODE | 29212 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +17143288090 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | shirley.baxley@sbcglobal.net |
| LAWFIRM NAME BUSINESS NAME | Shirley's Immigration Service |
| STATE OF HIGHEST COURT | |
| NAME OF HIGHEST STATE COURT | |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2801 Coffee Road |
| WORKSITE ADDRESS2 | Bldg B |
| WORKSITE CITY | Modesto |
| WORKSITE COUNTY | STANISLAUS |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 95355 |
| WAGE RATE OF PAY FROM | 91,998.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $91,998.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| 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 | Baxley |
| PREPARER FIRST NAME | Shirley |
| PREPARER MIDDLE INITIAL | J |
| PREPARER BUSINESS NAME | Shirley's Immigration Service |
| PREPARER EMAIL | shirley.baxley@sbcglobal.net |
| BEGIN DATE CONVERTED | 2024-01-10 |
