| CASE NUMBER | I-200-24353-555232 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/18/2024 |
| DECISION DATE | 12/27/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | ENDODONTIST |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| FULL TIME POSITION | N |
| BEGIN DATE | 1/6/2025 |
| END DATE | 1/5/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | NETWORK PROVIDER ASSOCIATES, P.C. |
| TRADE NAME DBA | DUNCANVILLE DENTAL CARE |
| EMPLOYER ADDRESS1 | 530 S MAIN STREET |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | ORANGE |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 92868 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17145713601 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | ROMANO |
| EMPLOYER POC FIRST NAME | RUTHIE |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | VP SONRAVA HEALTH DENTAL GROUP |
| EMPLOYER POC ADDRESS1 | 530 S MAIN STREET |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | ORANGE |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 92868 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17145713601 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | RECRUITING@WESTERNDENTAL.COM |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | GOLD |
| AGENT ATTORNEY FIRST NAME | DANA |
| AGENT ATTORNEY MIDDLE NAME | ANN |
| AGENT ATTORNEY ADDRESS1 | 1630 N. MAIN STREET |
| AGENT ATTORNEY ADDRESS2 | SUITE 44 |
| AGENT ATTORNEY CITY | WALNUT CREEK |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94596 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 19252320442 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | DANA@GOLDLAWOFFICES.COM |
| LAWFIRM NAME BUSINESS NAME | GOLD LAW OFFICES |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 715 W. WHEATLAND ROAD |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | DUNCANVILLE |
| WORKSITE COUNTY | DALLAS |
| WORKSITE STATE | TX |
| WORKSITE POSTAL CODE | 75116 |
| WAGE RATE OF PAY FROM | $125.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $118.14 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| 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 | SCHECHTER |
| PREPARER FIRST NAME | NIELY |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | GOLD LAW OFFICES |
| PREPARER EMAIL | NIELY@GOLDLAWOFFICES.COM |
| BEGIN DATE CONVERTED | 2025-01-06 |
