| CASE NUMBER | I-200-25069-761108 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/10/2025 |
| DECISION DATE | 3/17/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | ORTHODONTIST |
| SOC CODE | 29-1023.00 |
| SOC TITLE | Orthodontists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/9/2025 |
| END DATE | 9/8/2028 |
| 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 | Simply Dental Management, Inc. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 87 Elm St. |
| EMPLOYER ADDRESS2 | Suite 302 |
| EMPLOYER CITY | Hopkinton |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 1748 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15085898270 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Anderson |
| EMPLOYER POC FIRST NAME | Kate |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Recruiter |
| EMPLOYER POC ADDRESS1 | 87 Elm St. |
| EMPLOYER POC ADDRESS2 | Suite 302 |
| EMPLOYER POC CITY | Hopkinton |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 1748 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 19788210742 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | kanderson@simplydentalmanagement.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Lego |
| AGENT ATTORNEY FIRST NAME | Kellie |
| AGENT ATTORNEY MIDDLE NAME | Nicole |
| AGENT ATTORNEY ADDRESS1 | 1177 Annapolis Road, #70 |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Odenton |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 21113 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12403900600 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | Kellie@mvplg.com |
| LAWFIRM NAME BUSINESS NAME | MVP Law Group PA |
| STATE OF HIGHEST COURT | MD |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF MARYLAND |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | SIMPLY ORTHODONTICS PC |
| WORKSITE ADDRESS1 | 24 PUTNAM PIKE ROAD |
| WORKSITE ADDRESS2 | SUITE D |
| WORKSITE CITY | DAYVILLE |
| WORKSITE COUNTY | WINDHAM |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 6241 |
| WAGE RATE OF PAY FROM | $320,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $234,520.00 |
| 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 | 2 |
| 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 | 2025-09-09 |
