| CASE NUMBER | I-200-25007-599709 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/7/2025 |
| DECISION DATE | 1/15/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | N |
| BEGIN DATE | 1/14/2025 |
| END DATE | 1/13/2028 |
| 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 | AV Periodontics PLLC |
| TRADE NAME DBA | TetraHealth Dentistry |
| EMPLOYER ADDRESS1 | 4 Dearfield Dr |
| EMPLOYER ADDRESS2 | Ste. 104 |
| EMPLOYER CITY | Greenwich |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6831 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18603298729 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Volchonok |
| EMPLOYER POC FIRST NAME | Alexander |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Founding Partner |
| EMPLOYER POC ADDRESS1 | 4 Dearfield Dr |
| EMPLOYER POC ADDRESS2 | Ste 104 |
| EMPLOYER POC CITY | Greenwich |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 6831 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18603298729 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | volchonokdmd@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Chennoufi, Esq. |
| AGENT ATTORNEY FIRST NAME | Elena |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 99 Park Avenue |
| AGENT ATTORNEY ADDRESS2 | Floor 23 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10016 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12126863838 |
| AGENT ATTORNEY PHONE EXT | 202 |
| AGENT ATTORNEY EMAIL ADDRESS | echennoufi@barstlaw.com |
| LAWFIRM NAME BUSINESS NAME | Barst & Mukamal LLP |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | New York Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 4 Dearfield Dr |
| WORKSITE ADDRESS2 | Ste. 104 |
| WORKSITE CITY | Greenwich |
| WORKSITE COUNTY | FAIRFIELD |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 6831 |
| WAGE RATE OF PAY FROM | $110.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $140.00 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $98.50 |
| PW UNIT OF PAY | Hour |
| 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 | 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 | Chennoufi, Esq. |
| PREPARER FIRST NAME | Elena |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Barst & Mukamal LLP |
| PREPARER EMAIL | echennoufi@barstlaw.com |
| BEGIN DATE CONVERTED | 2025-01-14 |
