| LCA CASE NUMBER | I-200-21131-302879 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-05-11 |
| DECISION DATE | 2021-05-18 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Coast Dental of Georgia, PC |
| EMPLOYER ADDRESS1 | 5706 Benjamin Center Drive |
| EMPLOYER ADDRESS2 | Suite 103 |
| EMPLOYER CITY | Tampa |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33634 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18132881999 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Shah |
| EMPLOYER POC FIRST NAME | Dipawali |
| EMPLOYER POC JOB TITLE | Senior Vice President, General Counsel |
| EMPLOYER POC ADDRESS 1 | 5706 Benjamin Center Drive |
| EMPLOYER POC ADDRESS 2 | Suite 103 |
| EMPLOYER POC CITY | Tampa |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33634 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18132881999 |
| EMPLOYER POC PHONE EXT | 275 |
| EMPLOYER POC EMAIL | Dipa.Shah@coastdental.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Ramos |
| AGENT ATTORNEY FIRST NAME | Maria del Carmen |
| AGENT ATTORNEY ADDRESS1 | 101 E. Kennedy Blvd. |
| AGENT ATTORNEY ADDRESS2 | Suite 2800 |
| AGENT ATTORNEY CITY | Tampa |
| AGENT ATTORNEY STATE | FL |
| AGENT ATTORNEY POSTAL CODE | 33602 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | FLORIDA |
| AGENT ATTORNEY PHONE | 18132272252 |
|
| AGENT ATTORNEY EMAIL ADDRESS | mramos@shumaker.com |
| LAWFIRM NAME BUSINESS NAME | Shumaker, Loop & Kendrick, LLP |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Florida Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 3721 New MacLand Road |
| WORKSITE ADDRESS2 | Suite #210 |
| LCA CASE WORKLOC1 CITY | Powder Springs |
| WORKSITE COUNTY | COBB |
| LCA CASE WORKLOC1 STATE | GA |
| WORKSITE POSTAL CODE | 30127 |
| LCA CASE WAGE RATE FROM | 84.2 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 84.2 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Ramos |
| PREPARER FIRST NAME | Maria del Carmen |
| PREPARER BUSINESS NAME | Shumaker, Loop & Kendrick, LLP |
| PREPARER EMAIL | mramos@shumaker.com |
