| LCA CASE NUMBER | I-200-21028-041101 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-28 |
| DECISION DATE | 2021-02-04 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | DENTIST-GENERAL |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-04-20 |
| END DATE | 2024-04-19 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Bhavin Changela DDS Inc |
| TRADE NAME DBA | Pearl Dental Care |
| EMPLOYER ADDRESS1 | 2407 Valley Blvd |
| EMPLOYER ADDRESS2 | Suite C |
| EMPLOYER CITY | Pomona |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 91768 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19098391004 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | CHANGELA |
| EMPLOYER POC FIRST NAME | BHAVIN |
| EMPLOYER POC MIDDLE NAME | H |
| EMPLOYER POC JOB TITLE | President/DDS |
| EMPLOYER POC ADDRESS 1 | 2407 Valley Blvd |
| EMPLOYER POC ADDRESS 2 | Suite C |
| EMPLOYER POC CITY | Pomona |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 91768 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19098391004 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Baxley |
| AGENT ATTORNEY FIRST NAME | Shirley |
| AGENT ATTORNEY ADDRESS1 | 2121 West Jester Way |
| AGENT ATTORNEY CITY | Post Falls |
| AGENT ATTORNEY STATE | ID |
| AGENT ATTORNEY POSTAL CODE | 83854 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17143288090 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Shirley's Immigration Service |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 2407 Valley Blvd |
| WORKSITE ADDRESS2 | Suite C |
| LCA CASE WORKLOC1 CITY | Pomona |
| WORKSITE COUNTY | LOS ANGELES |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 91768 |
| LCA CASE WAGE RATE FROM | 141814 |
| LCA CASE WAGE RATE TO | 145000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 141814 |
| PW UNIT OF PAY | Year |
| 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 | Baxley |
| PREPARER FIRST NAME | Shirley |
| PREPARER BUSINESS NAME | Shirley's Immigration Service |
| PREPARER EMAIL | [email protected] |
