| CASE NUMBER | I-200-24344-528860 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/9/2024 |
| DECISION DATE | 12/16/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dentist - Periodontist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/6/2025 |
| END DATE | 1/5/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Advanced Periodontics and Implant Care, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 723 Co Rd 46 |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Lady Lake |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 32159 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 13527504075 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Nagaraj |
| EMPLOYER POC FIRST NAME | Chitra |
| EMPLOYER POC MIDDLE NAME | V. |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 723 Co Rd 466 |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Lady Lake |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 32159 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 13527504075 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | drchitravn@yahoo.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Michailov |
| AGENT ATTORNEY FIRST NAME | Dimitar |
| AGENT ATTORNEY MIDDLE NAME | R. |
| AGENT ATTORNEY ADDRESS1 | 4800 Hampden Lane |
| AGENT ATTORNEY ADDRESS2 | Suite 200 |
| AGENT ATTORNEY CITY | Bethesda |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 20814 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 18888784721 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | dimo.michailov@cilawgroup.com |
| LAWFIRM NAME BUSINESS NAME | Capitol Immigration Law Group PLLC |
| STATE OF HIGHEST COURT | DC |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 723 Co Rd 46 |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Lady Lake |
| WORKSITE COUNTY | LAKE |
| WORKSITE STATE | FL |
| WORKSITE POSTAL CODE | 32159 |
| WAGE RATE OF PAY FROM | $400,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $262,392.00 |
| PW UNIT OF PAY | Year |
| 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 | Michailov |
| PREPARER FIRST NAME | Dimitar |
| PREPARER MIDDLE INITIAL | R |
| PREPARER BUSINESS NAME | Capitol Immigration Law Group PLLC |
| PREPARER EMAIL | dimo.michailov@cilawgroup.com |
| BEGIN DATE CONVERTED | 2025-01-06 |
