| LCA CASE NUMBER | I-200-21222-512055 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-08-10 |
| DECISION DATE | 2021-08-16 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| 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 | Familia Dental Fort Wayne PLLC |
| EMPLOYER ADDRESS1 | 5328 Coldwater Rd. |
| EMPLOYER CITY | Fort Wayne |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46825 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12604715016 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Cendrowski |
| EMPLOYER POC FIRST NAME | Barabara |
| EMPLOYER POC JOB TITLE | Recruitment Specialist |
| EMPLOYER POC ADDRESS1 | 2050 E. Algonquin Rd. |
| EMPLOYER POC ADDRESS2 | Suite 610 |
| EMPLOYER POC CITY | Schaumburg |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 60173 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18478018365 |
| EMPLOYER POC EMAIL | bcendrowski@familiadental.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Wu |
| AGENT ATTORNEY FIRST NAME | Mark |
| AGENT ATTORNEY ADDRESS1 | 301 Congress Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 1150 |
| AGENT ATTORNEY CITY | Austin |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 78701 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15123444707 |
| AGENT ATTORNEY EMAIL ADDRESS | emily.ellison@ogletreedeakins.com |
| LAWFIRM NAME BUSINESS NAME | Ogletree, Deakins, Nash, Smoak & Stewart, P.C. |
| STATE OF HIGHEST COURT | GA |
| NAME OF HIGHEST STATE COURT | Georgia Superior Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 5328 Coldwater Rd. |
| LCA CASE WORKLOC1 CITY | Fort Wayne |
| WORKSITE COUNTY | ALLEN |
| LCA CASE WORKLOC1 STATE | IN |
| WORKSITE POSTAL CODE | 46825 |
| LCA CASE WAGE RATE FROM | 96117 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 96117 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Ellison |
| PREPARER FIRST NAME | Emily |
| PREPARER BUSINESS NAME | Ogletree, Deakins, Nash, Smoak & Stewart, P.C. |
| PREPARER EMAIL | emily.ellison@ogletreedeakins.com |
