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Case Number: A-20351-33795

Fiscal year: 2021

Fiscal Year

2021

Case Number

A-20351-33795

Case Status

Certified

Received Date

2021-01-21

Decision Date

2021-07-06

Refile

N

Original File Date

2021-01-01 09:46:10

Previous SWA Case Number State

Schedule A Sheepherder

N

Employer Name

LAKEWOOD FAMILY DENTAL INC

Employer Name Slug

lakewood-family-dental-inc

Employer Address 1

4512 PARNELL AVE

Employer Address 2

Employer City

FORT WAYNE

Employer City Slug

fort-wayne

Employer State

INDIANA

Employer State Slug

indiana

Employer Country

UNITED STATES OF AMERICA

Employer Postal Code

46825

Employer Phone

2603991333

Employer Number of Employees

9

Employer Year Commenced Business

2014

NAICS Code

621210

FW Ownership Interest

N

Employer Contact Name

Srinivasulu Kakollu

Employer Contact Address 1

4512 Parnell Ave

Employer Contact Address 2

Employer Contact City

FORT WAYNE

Employer Contact State/Province

INDIANA

Employer Contact Country

UNITED STATES OF AMERICA

Employer Contact Postal Code

46825

Employer Contact Phone

2603991333

Employer Contact Email

drnivas2000@gmail.com

Agent Attorney Name

KELLIE N LEGO

Agent Attorney Firm Name

MVP LAW GROUP, PA

Agent Attorney Phone

240-390-0600

Agent Attorney Address 1

10632 LITTLE PATUXENT PARKWAY, BUILDING 2000

Agent Attorney Address 2

SUITE 406

Agent Attorney City

COLUMBIA

Agent Attorney State/Province

MARYLAND

Agent Attorney Country

UNITED STATES OF AMERICA

Agent Attorney Postal Code

21044

Agent Attorney Email

KELLIE@MVPLG.COM

PW Track Number

P10020184692887

PW SOC Code

29-1021

PW SOC Title

Dentists, General

PW Skill Level

N/A

PW Wage

208000.00

PW Unit of Pay

Year

PW Wage Source

OES

PW Determination Date

2020-11-09

PW Expiration Date

2021-06-30

Wage Offer From

208000.00

Wage Offer To

0.00

Average Salary

208000.00

Wage Unit of Pay

Year

Worksite Address 1

4512 PARNELL AVENUE

Worksite Address 2

Worksite City

FORT WAYNE

Worksite City Slug

fort-wayne

Worksite State

INDIANA

Worksite Postal Code

46825

Job Title

ASSOCIATE DENTIST

Job Title Slug

associate-dentist

Minimum Education

Other

Major Field of Study

DENTAL SURGERY, DENTAL MEDICINE

Required Training

N

Required Experience

Y

Required Experience Months

12

Accept Alternative Field of Study

N

Accept Alternative Major Field of Study

Accept Alternative Combination

N

Accept Alternative Combination Education

Accept Alternative Combination Education Years

Accept Foreign Education

Y

Accept Alternative Occupation

N

Accept Alternative Occupation Months

Accept Alternative Job Title

Job Opportunity Requirements Normal

Y

Foreign Language Required

N

Specific Skills

INDIANA STATE DENTAL LICENSE; ANDbr KNOWLEDGE OF THE DIAGNOSIS AND TREATMENT OF ORAL AND DENTAL CONDITIONS

Combination Occupation

N

Offered to Applicant Foreign Worker

Y

Foreign Worker Live on Premises

N

Foreign Worker Live in Domestic Service

N

Foreign Worker Live in Domestic Service Count

Professional Occupation

Y

Application for College/University Teacher

N

SWA Job Order Start Date

2020-11-11

SWA Job Order End Date

2020-12-16

Sunday Edition Newspaper

Y

First Newspaper Name

THE JOURNAL GAZETTE

First Advertisement Start Date

2020-11-15

Second Newspaper Ad Name

THE JOURNAL GAZETTE

Second Advertisement Type

Newspaper

Second Ad Start Date

2020-11-22

Employer Website From Date

2020-11-16

Employer Website To Date

2020-12-01

Professional Organization Ad From Date

2021-01-01 09:46:10

Professional Organization Advertisement To Date

2021-01-01 09:46:10

Job Search Website From Date

2020-11-15

Job Search Website To Date

2020-11-30

Employee Referral Program From Date

2021-01-01 09:46:10

Employee Referral Program To Date

2021-01-01 09:46:10

Local Ethnic Paper From Date

2020-11-20

Local Ethnic Paper To Date

2020-11-20

Radio/TV Ad From Date

2021-01-01 09:46:10

Radio/TV Ad To Date

2021-01-01 09:46:10

Employer Received Payment

N

Posted Notice at Worksite

Y

Layoff in Past Six Months

N

Country of Citizenship

INDIA

Foreign Worker Birth Country

INDIA

Class of Admission

H-1B

Foreign Worker Education

Other

Foreign Worker Information: Major

DENTAL SURGERY

Foreign Worker Years of Education Completed

2017

Foreign Worker Institution of Education

NEW YORK UNIVERSITY

Foreign Worker Education Institution Address 1

345 E. 24TH STREET

Foreign Worker Education Institution Address 2

Foreign Worker Education Institution City

NEW YORK

Foreign Worker Education Institution State/Province

NY

Foreign Worker Education Institution Country

UNITED STATES OF AMERICA

Foreign Worker Education Institution Postal Code

10010

Foreign Worker Experience with Employer

N

Foreign Worker Employer Pays for Education

N

Foreign Worker Currently Employed

Y

Employer Completed Application

N

Preparer Name

KELLIE N LEGO

Preparer Title

ATTORNEY

Preparer Email

KELLIE@MVPLG.COM

Employer Information Declaration Name

KAKOLLU SRINIVASULU

Employer Information Declaration Title

OWNER